Profile: Christos Liapis

5th October 2005

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Vascular News talks to Christos D Liapis, Director of the first Vascular Surgery Department of the Athens University Medical School, and current President of the Hellenic Society for Vascular and Endovascular Surgery, and European Society for Vascular Surgery.

Fatherly influence

Born in Kalabaka, Greece, in 1947, it was not long before the young Christos Liapis decided that he wanted to pursue a career in medicine. “I think I was around seven years old, when I knew I wanted to become a doctor. My father was the doctor in my hometown and his office or surgery was located in our house; therefore, there were always people around.

“It seemed to me that our house was the centre, a meeting point of the whole town. I remember coming home from school and our house was always bustling, with people coming and going – it was like the whole community there.

“But it was not only because the house was so busy. At such an early age, I could see my father was respected throughout the whole town and this stuck with me. Everybody knew my father, consequently everybody knew me. As a young boy, this made an impression on me – I wanted to be respected like my father, so choosing a career in medicine was not a difficult choice.”

However, the influence of his father was not just restricted to the choice of his future profession. “This was not the only big influence my father had on me. I have never smoked and never will. When I was five years old someone had left a cigarette burning in an ashtray and I picked it up. Everyone moved towards me to take it away, but my father said, ‘No, let him try.’ Obviously, I felt ill afterwards – in fact, the smell of cigarette smoke still makes me feel sick today.”

Liapis the Solider

After leaving school and graduating from university, Liapis says he was still unsure about his future. “I didn’t know what I wanted, after studying at Athens University; I had yet to decide which branch of medicine I wanted to go into. I always thought I wanted to become a doctor, a general practitioner. But I realised there were far many more options open to me. In particular, surgery had always interested me, but again, I was unsure of which specialty to enter.”

However, Liapis’ development was interrupted by his call up to the Greek armed forces, an event that would have a profound effect upon him. “After gaining my degree, it was necessary for me to enrol in the army, as part of our conscription. Owing to my qualifications, I was enlisted as a medic. I think this experience was the one that marked the direction of my career.”

“As a medic, the trauma injuries I witnessed were horrific. Seeing the injuries and the suffering of people had a big effect on me. After my experiences in the army, the choice was obvious and I chose surgery.”

Here comes Liapis!

“After qualifying as a specialist in general surgery, I gained a three-year fellowship in vascular surgery at Ohio State University, Columbus, under the direction of Williams Evans, who had a great influence on me. When I first entered vascular surgery it was not a separate specialty. It was no more than using a scalpel, aided by a radiologist. It is almost unrecognisable from the specialty it has become today. The training in the US was vastly different from the training at home. Of course, the main difference was in the resources we had at our disposal. In the US, the facilities were available, in Greece this was not the case – although nowadays things are much different, much improved.

“So going to the US was a good learning curve. The other difference was that in Greece, Vascular Surgery was just a small part of General Surgery; in the US it was much more a specialty. At the same time, my wife was with me in the US training to become an architect, so we were both very busy.

“After Ohio, I moved to Boston where I did a one-year research fellowship in surgery at Harvard University and a research fellowship in cardiovascular surgery at Massachusetts General Hospital, under William Buckley. Boston is a splendid city and I learned (besides the use of LVAD) sailing.” However, Liapis returned to his home country and Athens University and decided to put into practice what he had learnt during his time in the US.

“Fortunately, Greece has a long tradition of great vascular surgeons and I was very much influenced and helped by outstanding vascular surgeons in my hospital of the calibre of Professors G Skalkeas, P Balas, M Sechas, A Kostakis and E Bastounis. I became involved in trying to create a vascular specialty. I felt that by making vascular surgery separate it would bring great benefits to everyone concerned because this is a distinct entity involving open surgical, endovascular and conservative treatment. For us professionals, we could start proper vascular training methods and not just those taught by general surgery. Also, this would benefit the patients because they would gain from the expertise of a trained vascular surgeon.”

Indeed, Liapis’ belief in training can be seen in his influential role as Secretary-General and Treasurer of the UEMS Division and Board of Vascular Surgery (1999-2004), where he played a key part in the board examinations, the development of the Logbook and the CME committee evaluating vascular events all over Europe. “I was working with great personalities such as B Nachbur, D Bergqvist and J Wolfe. Training was always one of my strong interests and my recent honorary membership of the European Society for Vascular Surgeons in Training, has been a very gratifying reward.”

Consequently, and as a result of Liapis’ efforts together with Roger Greenhalgh, and Fabrizio Benedetti-Valentini, vascular surgery was created as an independent Specialty Section in Europe, on 15 October 2004.”The UEMS Section of Vascular Surgery gives vascular surgeons the opportunity to speak as a body and this is very important; but we must follow the waves of change, and we have to prove that we are worthy of the independence”, says Liapis.

President Liapis

In September 2004, Liapis was elected as President of the European Society for Vascular Surgery, a position he says “is a great honour and also a great responsibility.”

“I think the great challenge today is the need to educate people about vascular disease. Smoking in particular is still killing, yet people are still smoking. The same stands true for lipids. This is not only the case in Western Europe, but in Eastern Europe too, where vascular disease is very concerning – and education is the key. I think it is our responsibility to try and foster greater relationships with Eastern Europe.”

“As a result, the European Society for Vascular Surgery’s Vascular Disease Foundation was created to increase public awareness of the prevention, diagnosis and management of vascular disease. As president I have highlighted the emergence of peripheral artery disease as the next area we need to confront; we have started to do so by establishing, together with the Secretary H Sillesen and the Council, the European Peripheral Arterial Disease Public Awareness Programme and European Guidelines Committees for taking care of critical issues, like carotid disease.”

Liapis acknowledges that the fight must not come only from societies, but also corporations. “So we are trying to gain the involvement of different societies, but more so, of industry. We are encouraging all types of businesses to become involved, from banks to car manufacturers; we are trying to make it a multi-national influence because without their commitment it is going to be very difficult.”

“But, this is a good example of how our profession has changed. Now it is just as important to educate as well as treat. Before, you would see a patient, operate, and see them after and then no more. Now – we are much more aimed towards patient care and awareness – and that is how it should be. It is our responsibility to educate the patient about the dangers of, for example, smoking, and how this aggravates vascular diseases. So, it is good that we have changed in such a way that we are now closer to the patient – and of course they are closer to us. We are now there, holding their hand and this can only benefit us both.”

Outside of Surgery

“Of course, I am very busy and it is difficult for my wife and me to find time together with so many different commitments. I wish I did have more free time. If I did, I would spend more time out mountain trekking; it is a very enjoyable and easy way to relax, it gives me time to think, but tennis, swimming and beach volley are also activities I greatly enjoy.”

“We would also like to spend more time with our sons, but they are busy with their studies and we are also busy. My younger son is studying laser physics at Imperial College, London, and my older son is studying biotechnology in Greece (I understand nothing of either discipline) – so it seems they will not go into medicine. I think my father did a better job in influencing me to go into medicine than I have done with my sons!”

“My other passion is football which I admit to being fanatical about. I was very happy last year when we (Greece) won the European Championships in Portugal. I was very happy indeed.”